静止心率与心肌梗塞稳定患者的长期结果之间的关系:一个前性社区基队列研究
Lina Xu1, Yonggang Chen2, Shuohua Chen3
1Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
心肌梗塞 (MI) 后静止心率 (RHR) 升高预示着更糟糕的结果. 后心脏病患者的RHR超过72bpm面临死亡和心力衰竭住院的风险增加.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 住院期间的休息心率 (RHR) 与心肌梗塞 (MI) 患者的不良结果有关.
- 在心脏病发作后稳定阶段RHR的预后意义需要进一步调查.
研究的目的:
- 评估RHR在心脏病发作后稳定阶段测量的长期预后影响.
- 确定RHR水平与心血管重大不良事件在后MI个体之间的关联.
主要方法:
- 利用了基于社区的Kailuan研究 (2006-2018) 的数据,包括以前或新发作的MI患者.
- 将RHR分类为四分位数,并使用考克斯回归分析来评估与复合结果的关联 (全因死亡,HF住院,中风,复发性心脏病).
主要成果:
- 包括4447名心脏病发作后患者,平均随访时间为7.5年;40.8%的患者经历了初级结局.
- 与RHR≤67bpm相比,RHR>80bpm增加了主要结果的风险 (aHR1.35;95%CI1.18-1.55).
- 每增加10bpm的RHR与12%更高的初级结局风险相关,所有原因的死亡和HF住院.
结论:
- 在心脏病发作后的稳定阶段,静止心率是不良结果和全因死亡率的独立预测因素.
- 超过72bpm的RHR显著与心血管重大不良事件和死后心脏病患者的风险增加有关.
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